NCLEX-RN NGN Exam Questions & Answers | Clinical
Case Scenarios + Rationales | Graded A+ Study Guide
1. Heart Failure
A client has crackles, edema, and dyspnea. SpO₂ is 86%.
What is priority?
A. Give diuretics
B. Apply oxygen
C. Restrict fluids
D. Elevate legs
Answer: B
Rationale: Oxygen first for hypoxia.
2. Diabetes
Blood glucose = 50 mg/dL, client is conscious.
A. IV insulin
B. 15g glucose
C. Long-acting insulin
D. Recheck in 1 hr
Answer: B
Rationale: Treat hypoglycemia immediately with fast carbs.
3. Sepsis
BP 80/40, HR 130, fever.
A. Antibiotics
B. IV fluids
C. Blood culture
D. CT scan
Answer: B
,Rationale: Fluids restore perfusion first.
4. Stroke
Which is most concerning?
A. Mild headache
B. Unequal grip strength
C. BP 150/90
D. Fatigue
Answer: B
Rationale: Neurological deficit = stroke progression.
5. COPD
What indicates worsening condition?
A. Barrel chest
B. CO₂ retention confusion
C. Productive cough
D. Wheezing
Answer: B
6. Post-op bleeding
HR 120, BP 90/60, soaked dressing.
A. Reinforce dressing
B. Notify provider
C. Document
D. Turn patient
Answer: B
7. Infection control
MRSA wound requires:
A. Airborne
, B. Contact
C. Droplet
D. Standard only
Answer: B
8. Asthma attack
Severe wheezing, can’t speak.
A. Albuterol
B. Antibiotics
C. Oxygen only
D. Steroid PO
Answer: A
9. Chest pain
Most urgent client:
A. Stable post-op
B. Chest pain 8/10
C. Mild COPD
D. Discharge teaching
Answer: B
10. Hyperkalemia
K⁺ = 6.5
A. Calcium gluconate
B. Potassium IV
C. Banana diet
D. Lasix only
Answer: A
11. Hypokalemia
Case Scenarios + Rationales | Graded A+ Study Guide
1. Heart Failure
A client has crackles, edema, and dyspnea. SpO₂ is 86%.
What is priority?
A. Give diuretics
B. Apply oxygen
C. Restrict fluids
D. Elevate legs
Answer: B
Rationale: Oxygen first for hypoxia.
2. Diabetes
Blood glucose = 50 mg/dL, client is conscious.
A. IV insulin
B. 15g glucose
C. Long-acting insulin
D. Recheck in 1 hr
Answer: B
Rationale: Treat hypoglycemia immediately with fast carbs.
3. Sepsis
BP 80/40, HR 130, fever.
A. Antibiotics
B. IV fluids
C. Blood culture
D. CT scan
Answer: B
,Rationale: Fluids restore perfusion first.
4. Stroke
Which is most concerning?
A. Mild headache
B. Unequal grip strength
C. BP 150/90
D. Fatigue
Answer: B
Rationale: Neurological deficit = stroke progression.
5. COPD
What indicates worsening condition?
A. Barrel chest
B. CO₂ retention confusion
C. Productive cough
D. Wheezing
Answer: B
6. Post-op bleeding
HR 120, BP 90/60, soaked dressing.
A. Reinforce dressing
B. Notify provider
C. Document
D. Turn patient
Answer: B
7. Infection control
MRSA wound requires:
A. Airborne
, B. Contact
C. Droplet
D. Standard only
Answer: B
8. Asthma attack
Severe wheezing, can’t speak.
A. Albuterol
B. Antibiotics
C. Oxygen only
D. Steroid PO
Answer: A
9. Chest pain
Most urgent client:
A. Stable post-op
B. Chest pain 8/10
C. Mild COPD
D. Discharge teaching
Answer: B
10. Hyperkalemia
K⁺ = 6.5
A. Calcium gluconate
B. Potassium IV
C. Banana diet
D. Lasix only
Answer: A
11. Hypokalemia
